Journal of Health, Population, and Nutrition最新文献

Purpose: The association between nutritional risk status assessment and hospital mortality in older patients remains controversial. The aim of this study was to assess the relationship between nutritional risk on admission and in-hospital mortality, and explore the best Nutritional Risk Status Screening 2002 (NRS2002) threshold for predicting in-hospital mortality of older inpatients in China.

Method: The elderly inpatients were recruited from a hospital in Hunan Province, China. Nutritional risk was screened and assessed using the NRS2002. Logistic regression was used to analyze whether NRS2002 scores were independently associated with hospital mortality, and the results were expressed as odds ratios (OR) and 95% confidence intervals (CIs). Receiver operating characteristic curve (ROC) was used to determine the best NRS2002 threshold for predicting in-hospital mortality in elderly inpatients. And 500 bootstrap re-samplings were performed for ROC analysis.

Result: In total, 464 elderly inpatients completed the survey (15 of whom died, 205 males and 259 females, mean age = 72.284 ± 5.626 years). Multifactorial analysis revealed that age, the NRS2002 score, and length of hospital stay significantly influenced in-hospital mortality among older inpatients (P < 0.05). The results also showed that higher NRS2002 scores were associated with an increased risk of in-hospital mortality in both the unadjusted (OR = 1.731,95%CI = 1.362-2.20, P < 0.0001), adjusted model I (OR = 1.736, 95% CI = 1.354-2.206, P < 0.0001) and model II (OR = 1.602, 95% CI = 1.734-2.488, P = 0.0005). The optimal NRS2002 threshold for predicting in-hospital mortality in older inpatients was 3.5, with the largest ROC area of 0.84.

Conclusion: Our findings indicated that nutritional risk was an independent predictor of in-hospital mortality, with a cut-off value of 3.50 for the NRS2002 nutritional risk assessment being more appropriate than a cut-off value of 3.0.

Anemia is a disorder of decreased erythrocyte mass. Indonesia is one of the countries with the highest (31.2%) prevalence of anemia among women of childbearing age in Southeast Asia in 2019. Women currently play a dual role, not only as housewives but also play a role in the public sector namely working outside the home. Women workers in the oil palm plantation sector generally experience health problems such as maternal mortality rate, malnutrition, poor pregnancy care and delivery services, and anemia. The purpose of this study was to uncover nutrition situation among women workers in the oil palm plantation sector at company X, Central Kalimantan Province, company Y, Riau Province and company Z, South Papua Province. The study design was cross-sectional which involved 105 respondents of women workers selected purposively in the study areas. Data were obtained from field measurement of hemoglobin, semi quantitative food frequency questionnaire and other questionnaire. This study found that almost half (45.7%) of respondent were anemic and around 48.6% were overweight. Around 20% were both anemic and overweight. Low iron intake, low vitamin C intake, high calcium intake, multiparity, and poor physical environment condition were all significantly related to higher risk of anemia. Various causes of anemia should be considered in intervention or supplementation program. A combination of nutrition and other health surveillance would be suggested not only to alleviate but also to prevent the problem.

Background: The link between regional body fat distribution and overactive bladder (OAB) in prior epidemiological research has been uncertain. Our objective is to assess the relationship between increased regional body fat and the prevalence of OAB.

Methods: Within this analysis, 8,084 individuals aged 20 years and older were selected from NHANES surveys conducted from 2011 to 2018. The evaluation of OAB symptoms utilized the overactive bladder symptom score (OABSS). Fat mass (FM) across various regions was quantified employing dual-energy X-ray absorptiometry, which assessed total FM, trunk FM, arm FM, and leg FM. The fat mass index (FMI) was calculated as the ratio of fat mass (kg) to the square of height (meters). Data weighting was performed in accordance with analysis guidelines. A linear logistic regression model was employed to assess the correlation between regional FMI and the occurrence of OAB. Stratified analyses were also conducted.

Results: The study found significant associations between total FMI and limb FMI with OAB. After adjusting for all variables in the analysis, higher total FMI (OR = 1.07, 95% CI = 1.02-1.12) was linked to an increased risk of OAB. Trunk FMI (OR = 1.12, 95% CI = 1.03-1.22), arm FMI (OR = 1.59, 95% CI = 1.20-2.10), and leg FMI (OR = 1.12, 95% CI = 1.01-1.25) demonstrated significant correlations with OAB. The weighted associations between total FMI and limb FMI with OAB incidence showed no significant differences among most subgroups.

Conclusions: The data indicates a correlation between higher regional FMI and increased OAB risk across different populations.

Background: Foodborne illness is a significant public health concern, particularly in developing countries like Bangladesh. Young adults, aged 18-26 (including undergraduates and recent graduates), are especially vulnerable to the onset of unhealthy eating habits and nutritional imbalances as they begin living independently, often away from their families. This research aims to identify the risk factors associated with the knowledge, attitudes, and practices related to safe food handling among residential university students. By understanding these factors, the study seeks to inform strategies to improve food safety behaviors in this at-risk population.

Methods: A standardized questionnaire was administered through a simple random sampling survey of 250 students at Jahangirnagar University to collect primary data on food safety practices, attitudes, and knowledge. Descriptive statistics and the chi-square test were used to examine associations between the responses and predictor variables. To further assess the statistical significance and strength of these relationships, logistic regression analyses were performed. These methods provided a comprehensive evaluation of the factors influencing safe food handling behaviors among the students.

Results: The survey found that most participants were from rural areas (44.4%) and female students (65.2%). Multicollinearity issues were not detected, and predictor factors explained 53.8% (Nagelkerke R-square: 0.538) of the variation in food poisoning incidents. Overall, 57.6% of students reported being prone to food poisoning. Risk factors for food poisoning included being in the third year of study (OR: 3.493, CI: 0.394-30.972), consuming food during a blackout based on its appearance or scent (OR: 4.824, CI: 0.690-33.715), and believing food should be refrigerated for five to seven days (OR: 2.309, CI: 0.318-16.778). Conversely, students who stored raw meat or fish on the middle shelf (OR: 0.078, CI: 0.012-0.511) and those who thought leftover food should be kept in the fridge for more than seven days (OR: 0.034, CI: 0.002-0.626) were less likely to experience food poisoning. These findings highlight behaviors that influence foodborne illness risk among students.

Conclusions: This study found that while students in Bangladesh demonstrate a strong understanding of food handling, there has been insufficient focus on food safety education in the country. Based on these findings, the authors recommend enhancing awareness of key food safety risks and integrating this knowledge into both short- and long-term initiatives. To ensure lasting improvements in food safety, sustained and effective interventions are essential. These efforts will accelerate progress toward achieving the sustainable development goals related to public health in Bangladesh.

Nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant global public health dilemma with wide-ranging social and economic implications. Diet and lifestyle modifications remain essential components of NAFLD management. The current study investigated the association between diet-related inflammation and NAFLD among 3110 Iranian adults participating in the Amol Cohort Study (AmolCS), employing the Structural Equation Modeling (SEM) approach.The inflammatory potential of the diet was quantified using an energy-adjusted dietary index (E-DII) score. Findings showed that in the total sample and separately in males, the E-DII score had a significant effect on NAFLD, with mediation through hypertension (β_standardized = 0.16, and 0.13, p < 0.001, respectively) and c-reactive protein (CRP) (β_standardized = 0.07, and 0.07, p < 0.001, respectively). In the total sample and separately in females, the E-DII score significantly affected NAFLD, with mediation through diabetes (β_standardized = 0.06, p < 0.001, and 0.07, p = 0.006, respectively). In full and both gender-specific models, dyslipidemia was a risk factor for NAFLD and partially mediated the effect of hypertension on NAFLD.The current study concluded a mediated association between dietary inflammation and NAFLD through hypertension, CRP, diabetes, and dyslipidemia, suggesting further longitudinal studies, especially in high-risk populations. These findings underscore the complex interplay between diet, inflammation, and NAFLD in Iranian adults.

Background: Tuberculosis (TB) remains a global health challenge, with 1.3 million deaths in 2022. Ten countries in the European Union (EU) and European Economic Area (EEA) accounted for 88.3% of TB cases, of which 23.8% were from Romania. Evidence shows that mental health issues, decreased quality of life and negative socio-economic impact are common among TB patients; however, there is limited evidence available in Romania. The main aim of this study is to longitudinally assess the quality of life, mental health, and socio-economic status of patients with drug-resistant TB (DR TB) in Romania.

Methods: A prospective cohort study was conducted at the Marius Nasta Institute of Pneumology in Bucharest, Romania, enrolling 50 participants with DR TB. Demographic data, clinical examinations, laboratory test and medical history were recorded at study start. At baseline (week two), month 10, and month 20 we also administered the Short-Form-36 and Kessler Psychological Distress Scale to assess health-related quality of life and mental health status, and socio-economic questionnaires to 46 participants.

Results: Of the 46 participants with median age of 48.9 years, 71.7% were males. Majority of the participants were employed at the baseline but due to the rigorous treatment and hospitalization had to take sick leave, thereby affecting the individual and household income. 26.1% and 39.3% of participants reported psychological distress at baseline and at the end of month 20, respectively. The quality-of-life scores improved during treatment: PCS with a mean of 67.0 (SD-33.9) at baseline, 63.3 (SD-31.9) at month 10 and 70.3 (SD-30.3) at month 20, and MCS with 62.8 (SD-30.6), 67.8 (SD-29) and 70.8 (SD-27.3), accordingly, but differences were not significant.

Conclusions: We examined the socio-economic impact, quality of life, and psychological distress among patients affected by DR TB in Romania. The results of this study suggest that social and psychological support will ensure a better standard of living during and following TB treatment.

Background: Food insecurity is an important aspect of human suffering during wartime. Besides its ferocity, the Gaza conflict of 2023-2024 has been marked by severe food and medication shortages that exacerbated the human toll and worsened the suffering of the population.

Methods: A cross-sectional, mixed methods study that in April 2024 collected quantitative and qualitative data to assess food insecurity and malnutrition among residents of the Northern part of the Gaza Strip during the first seven months of the war. Quantitative data assessed weight loss among participants as a marker of starvation. Qualitative interviews evaluated food availability, food variability, and changing eating habits. Demographics were represented as counts and percentages. Weight was reported as mean ± SD. The Spearman Correlation Coefficient evaluated potential correlations of weight loss with sex, place of residence, and age. Statistical significance was set at a p-value less than 0.05.

Results: 497 participants were recruited, including 330 males (66.4%) and 167 females (33.6%). The age range was (13-83 years). The mean baseline weight was 84.94 kg ± 20.06, with a weight range (35-180 kg). In April 2024, the mean weight had dropped to 66.22 kg ± 14.34, representing an average decline of 18.72 kg (new weight range 28-142 kg). Age was associated with a weak positive correlation with weight loss (r = .204, p = .000). Qualitative interviews with 95 breadwinners or homemakers revealed a high prevalence of hunger and severe shortages in food quantity, quality, and variability. Physical and financial barriers significantly impacted food sourcing. Also, due to food shortages, most participants reported high consumption of edible wild plants and unconventional types of flour such as corn flour or grounded animal feed.

Conclusions: The study demonstrated high levels of weight loss and marked food insecurity in the Northern Gaza Strip during the conflict. The quantitative and qualitative food shortages outlined in this study present a risk for a host of potentially serious and irreversible future complications.

Background: Malnutrition among children remains a critical public health challenge in India. WHO's IYCF model recommends that children should feed on five out of eight food categories daily. The objective of the study is to assess dietary diversity and associated risk factors among children, focusing on complex interplay of socio-economic and demographic factors.

Methods: The study utilized nationally representative data from the National Family Health Survey (NFHS-5) conducted in 2019-2021, focusing on a sample of 62,553 children aged 6-24 months. Minimum Dietary Diversity (MDD) was assessed using children received foods from ≥ 5 food group out of eight specified food groups over the 24 h preceding the survey. Logistic regression employed to examine the association between DD and its predictors (p value < 0.05).

Results: Overall, 52% of the children were male, while the remaining 48% were female. Only 23.3% of the children across India achieved MDD. Mother's education was positively associated with dietary diversity (OR:1.15; 95% CI:0.92-1.4). Factors significantly associated with dietary diversity were children aged 19-23 months (OR:4.03; CI:3.46-4.69), working mothers (OR:1.30; 95% CI:1.14-1.5) and children belonged to middle (OR:1.22; CI:1.05-1.43) and rich socio-economic status (OR:1.48; CI:1.26-1.8) as compared to their counterparts. Additionally, no difference found in dietary diversity among male and female children (OR:1.01; CI:0.9-1.11) and urban and rural areas (OR:101; CI:0.87-1.17). Those children belonged to Northeast region had around 70% higher dietary diversity as compared to Central region.

Conclusion: This study highlights a concerning low prevalence of dietary diversity among young children in India. Interventions and policies should target on implementing comprehensive nutrition education programs for caregivers, coupled with targeted financial support and community engagement.

Background: Individuals can learn their HIV status through voluntary HIV counseling and testing (VCT), which also serves as a crucial access point for prevention, treatment, care, and support programs. VCT has grown in significance as a component of HIV prevention and care in Ethiopia because of its viability and convenience for the wider community, as well as its ability to provide access to care, treatment, and support for those in need. However, studies on this topic are limited, particularly because the fidelity of Ethiopia's VCT program has not been evaluated or measured. Therefore, this study aimed to assess the current implementation status of VCT services and client satisfaction in public health facilities in Gondar City.

Methods: This cross-sectional study was conducted out from June to July 2022. This study involved 130 counselors and 423 VCT users. Information on physical facilities, client satisfaction, and counselor impressions of the services was gathered using a standardized and pre-tested questionnaire, observation checklists, and resource inventory checklists developed from Ethiopian national VCT guidelines, the World Health Organization, United Nations AIDS, and previous literature. In the bivariate and multiple logistic regression models, variables with p values ≤ 0.2 and < 0.05 were chosen as candidate variables and associated variables, respectively.

Results: The overall implementation and facility readiness for VCT services was found to be 67%. The overall client satisfaction rate was 71% (95% CI: 69.7%, 72.7%). Age of participants from 25 to 30 years (AOR = 1.11, 95% CI, 1.02-1.21), 31-35 years (AOR = 2.03, 95% CI, 1.88-2.18), higher educational status (AOR = 1.18, 95% CI, 1.03-2.01), and comprehensive knowledge of HIV/AIDS (AOR = 2.42, 95% CI, 1.53,3.32) were positively associated with client satisfaction, whereas fear of confidentiality (AOR = 0.42, 95% CI, 0.20, 0.63) and longer waiting time (AOR = 0.09, 95% CI, 0.04, 0.15) were negatively associated with the outcome variable.

Conclusion: The implementation fidelity was evaluated to be low; however, client satisfaction was somewhat good. Based on the descriptive and analytical findings, providers' adherence to standards, strong communication with leaders, and the preservation of client confidentiality and privacy must be ensured by having VCT centers meet the necessary standards as outlined in the HTC guidelines to increase client uptake and satisfaction. To enhance the quality of the program, it is important to address clients' educational levels, improve participants' understanding of VCT, promote youth participation, and provide training to service providers.

Background: Although many studies shown that the risk of congenital heart disease (CHD) was closely related to genetic and environmental factors, the exact mechanism was still unclear. This study was to assess the association of maternal folic acid supplementation (FAS), the 5-methyltetrahydrofolate-homocysteine methyltransferase reductase (MTRR) gene polymorphisms in offspring and their interaction effects with the risk of CHD and its subtypes.

Methods: A case-control study was conducted on 595 children with CHD and 605 healthy child controls. The multivariate logistic regression model was used to assess the association of maternal FAS, offspring MTRR gene polymorphisms and their interaction effects with CHD and its subtypes.

Results: This study shown that maternal FAS was significantly associated with a reduced risk of CHD (OR = 0.55, 95%CI: 0.36-0.83) and its subtypes including ASD (OR = 0.25, 95%CI: 0.14-0.45), VSD (OR = 0.42, 95%CI: 0.27-0.64), and CTD (OR = 0.23, 95%CI: 0.09-0.59) in offspring. Offspring MTRR gene polymorphisms at rs162048 (GG vs. AA: OR = 2.05, 95%CI: 1.35-3.13), rs1802059 (AA vs. GG: OR = 5.13, 95%CI: 2.15-12.23; GA vs. GG: OR = 1.81, 95%CI: 1.35-2.43), rs10380 (TT vs. CC: OR = 2.27, 95%CI: 1.20-4.31) and rs1801394 (GG vs. AA: OR = 1.58, 95%CI: 1.02-2.42) were significantly associated with the risk of CHD, and similar results were also found for three subtypes of CHD. Additionally, a statistically significant interaction effect between maternal FAS and offspring MTRR gene polymorphism at rs1802059 was observed (OR = 0.38, 95%CI: 0.15-0.94). Among children who had a variant genotype at rs1802059, the risk of CHD was significantly decreased when their mother used folate for this pregnancy compared with mothers not using folate.

Conclusions: In those of Chinese descent, maternal FAS and offspring MTRR gene polymorphisms are significantly associated with the risk of CHD and its three subtypes. Furthermore, maternal FAS may help to offset some of risks of CHD due to offspring MTRR genetic variants. However, more studies with prospective designs and larger samples are needed to confirm our findings.

Trial registration: Registration number: ChiCTR1800016635; Registration time: 14/06/2018.